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Araujo D, Greystoke A, Bates S, Bayle A, Calvo E, Castelo-Branco L, de Bono J, Drilon A, Garralda E, Ivy P, Kholmanskikh O, Melero I, Pentheroudakis G, Petrie J, Plummer R, Ponce S, Postel-Vinay S, Siu L, Spreafico A, Stathis A, Steeghs N, Yap C, Yap TA, Ratain M, Seymour L. Oncology phase I trial design and conduct: time for a change - MDICT Guidelines 2022. Ann Oncol 2023; 34:48-60. [PMID: 36182023 DOI: 10.1016/j.annonc.2022.09.158] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/18/2022] [Indexed: 02/03/2023] Open
Abstract
In 2021, the Food and Drug Administration Oncology Center of Excellence announced Project Optimus focusing on dose optimization for oncology drugs. The Methodology for the Development of Innovative Cancer Therapies (MDICT) Taskforce met to review and discuss the optimization of dosage for oncology trials and to develop a practical guide for oncology phase I trials. Defining a single recommended phase II dose based on toxicity may define doses that are neither the most effective nor the best tolerated. MDICT recommendations address the need for robust non-clinical data which are needed to inform trial design, as well as an expert team including statisticians and pharmacologists. The protocol must be flexible and adaptive, with clear definition of all endpoints. Health authorities should be consulted early and regularly. Strategies such as randomization, intrapatient dose escalation, and real-world eligibility criteria are encouraged whereas serial tumor sampling is discouraged in the absence of a strong rationale and appropriately validated assay. Endpoints should include consideration of all longitudinal toxicity. The phase I dose escalation trial should define the recommended dose range for later testing in randomized phase II trials, rather than a single recommended phase II dose, and consider scenarios where different populations may require different dosages. The adoption of these recommendations will improve dosage selection in early clinical trials of new anticancer treatments and ultimately, outcomes for patients.
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Affiliation(s)
- D Araujo
- Hospital de Base, Sao Jose do Rio Preto, Brazil
| | - A Greystoke
- Northern Centre for Cancer Care, Newcastle, UK
| | - S Bates
- Division of Hematology and Oncology, Department of Medicine, Columbia University, New York, USA
| | - A Bayle
- Institut Gustave Roussy, Paris, France
| | - E Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | - L Castelo-Branco
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - J de Bono
- Institute of Cancer Research, University of London, London; The Royal Marsden Hospital, London, UK
| | - A Drilon
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - E Garralda
- Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - P Ivy
- National Cancer Institute, USA Cancer Therapy Evaluation Program Investigational Drug Branch (NCI/CTEP/IDB), Bethesda, USA
| | - O Kholmanskikh
- European Medicines Agency, Amsterdam, Netherlands; Federal Agency for Medicines and Health Products, Brussels, Belgium
| | - I Melero
- CUN and CIMA, University of Navarra, Pamplona, Spain
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - J Petrie
- Canadian Cancer Trials Group, Queen's University, Kingston
| | - R Plummer
- Northern Centre for Cancer Care, Newcastle, UK
| | - S Ponce
- Institut Gustave Roussy, Paris, France
| | | | - L Siu
- Princess Margaret Cancer Centre, Toronto, Canada
| | - A Spreafico
- Princess Margaret Cancer Centre, Toronto, Canada
| | - A Stathis
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - N Steeghs
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Yap
- Institute of Cancer Research, University of London, London
| | - T A Yap
- Department of Investigational Cancer Therapeutics, University of Texas, MD Anderson Cancer Center, Houston
| | - M Ratain
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, USA
| | - L Seymour
- Canadian Cancer Trials Group, Queen's University, Kingston.
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Daza JF, Cuthbertson BH, Myles PS, Shulman MA, Wijeysundera DN, Wijeysundera DN, Pearse RM, Myles PS, Abbott TEF, Shulman MA, Torres E, Ambosta A, Melo M, Mamdani M, Thorpe KE, Wallace S, Farrington C, Croal BL, Granton JT, Oh P, Thompson B, Hillis G, Beattie WS, Wijeysundera HC, Ellis M, Borg B, Kerridge RK, Douglas J, Brannan J, Pretto J, Godsall MG, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Kirabiyik Y, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter TW, Macklin S, Elliott A, Carrera AM, Terblanche NCS, Pitt S, Samuels J, Wilde C, Leslie K, MacCormick A, Bramley D, Southcott AM, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney CJL, Choi S, Somascanthan P, Flores K, Karkouti K, Clarke HA, Jerath A, McCluskey SA, Wasowicz M, Day L, Pazmino-Canizares J, Belliard R, Lee L, Dobson K, Stanbrook M, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, McAllister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G. Measurement properties of the WHO Disability Assessment Schedule 2.0 for evaluating functional status after inpatient surgery. Br J Surg 2022; 109:968-976. [PMID: 35929065 DOI: 10.1093/bjs/znac263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/17/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Expert recommendations propose the WHO Disability Assessment Schedule (WHODAS) 2.0 as a core outcome measure in surgical studies, yet data on its long-term measurement properties remain limited. These were evaluated in a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) prospective cohort. METHODS Participants were adults (40 years of age or older) who underwent inpatient non-cardiac surgery. The 12-item WHODAS and EQ-5DTM-3L questionnaires were administered preoperatively (in person) and 1 year postoperatively (by telephone). Responsiveness was characterized using standardized response means (SRMs) and correlation coefficients between change scores. Construct validity was evaluated using correlation coefficients between 1-year scores and comparisons of WHODAS scores across clinically relevant subgroups. RESULTS The analysis included 546 patients. There was moderate correlation between changes in WHODAS and various EQ-5DTM subscales. The strongest correlation was between changes in WHODAS and changes in the functional domains of the EQ-5D-3L-for example, mobility (Spearman's rho 0.40, 95 per cent confidence interval [c.i.] 0.32 to 0.48) and usual activities (rho 0.45, 95 per cent c.i. 0.30 to 0.52). When compared across quartiles of EQ-5D index change, median WHODAS scores followed expected patterns of change. In subgroups with expected functional status changes, the WHODAS SRMs ranged from 'small' to 'large' in the expected directions of change. At 1 year, the WHODAS demonstrated convergence with the EQ-5D-3L functional domains, and good discrimination between patients with expected differences in functional status. CONCLUSION The WHODAS questionnaire has construct validity and responsiveness as a measure of functional status at 1 year after major surgery.
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Affiliation(s)
- Julian F Daza
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Brian H Cuthbertson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Mark A Shulman
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Duminda N Wijeysundera
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada
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La Zara D, Sun F, Zhang F, Franek F, Balogh Sivars K, Horndahl J, Bates S, Brännström M, Ewing P, Quayle MJ, Petersson G, Folestad S, van Ommen JR. Controlled Pulmonary Delivery of Carrier-Free Budesonide Dry Powder by Atomic Layer Deposition. ACS Nano 2021; 15:6684-6698. [PMID: 33769805 PMCID: PMC8155342 DOI: 10.1021/acsnano.0c10040] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
Ideal controlled pulmonary drug delivery systems provide sustained release by retarding lung clearance mechanisms and efficient lung deposition to maintain therapeutic concentrations over prolonged time. Here, we use atomic layer deposition (ALD) to simultaneously tailor the release and aerosolization properties of inhaled drug particles without the need for lactose carrier. In particular, we deposit uniform nanoscale oxide ceramic films, such as Al2O3, TiO2, and SiO2, on micronized budesonide particles, a common active pharmaceutical ingredient for the treatment of respiratory diseases. In vitro dissolution and ex vivo isolated perfused rat lung tests demonstrate dramatically slowed release with increasing nanofilm thickness, regardless of the nature of the material. Ex situ transmission electron microscopy at various stages during dissolution unravels mostly intact nanofilms, suggesting that the release mechanism mainly involves the transport of dissolution media through the ALD films. Furthermore, in vitro aerosolization testing by fast screening impactor shows a ∼2-fold increase in fine particle fraction (FPF) for each ALD-coated budesonide formulation after 10 ALD process cycles, also applying very low patient inspiratory pressures. The higher FPFs after the ALD process are attributed to the reduction in the interparticle force arising from the ceramic surfaces, as evidenced by atomic force microscopy measurements. Finally, cell viability, cytokine release, and tissue morphology analyses verify a safe and efficacious use of ALD-coated budesonide particles at the cellular level. Therefore, surface nanoengineering by ALD is highly promising in providing the next generation of inhaled formulations with tailored characteristics of drug release and lung deposition, thereby enhancing controlled pulmonary delivery opportunities.
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Affiliation(s)
- Damiano La Zara
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
| | - Feilong Sun
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
| | - Fuweng Zhang
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
| | - Frans Franek
- Advanced
Drug Delivery, Pharmaceutical Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Kinga Balogh Sivars
- Clinical
Testing and Precision Medicine, Global Procurement, Operations, AstraZeneca, Gothenburg, Sweden
| | - Jenny Horndahl
- Bioscience
COPD/IPF, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Stephanie Bates
- Functional
and Mechanistic Safety, Clinical Pharmacology
and Safety Sciences, R&D, AstraZeneca, Cambridge U.K.
| | - Marie Brännström
- Drug
Metabolism and Pharmacokinetics, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D,
AstraZeneca, Gothenburg, Sweden
| | - Pär Ewing
- Drug
Metabolism and Pharmacokinetics, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D,
AstraZeneca, Gothenburg, Sweden
| | - Michael J. Quayle
- New Modalities
and Parenteral Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Gothenburg, Sweden
| | - Gunilla Petersson
- Innovation
Strategy and External Liaison, Pharmaceutical Technology & Development, Operations, AstraZeneca, Gothenburg, Sweden
| | - Staffan Folestad
- Innovation
Strategy and External Liaison, Pharmaceutical Technology & Development, Operations, AstraZeneca, Gothenburg, Sweden
| | - J. Ruud van Ommen
- Department
of Chemical Engineering, Delft University
of Technology, Van der Maasweg 9, Delft, 2629HZ, The Netherlands
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4
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Evans RL, Bates S, Marriott RE, Arnold DS. The impact of different hair-removal behaviours on the biophysical and biochemical characteristics of female axillary skin. Int J Cosmet Sci 2020; 42:436-443. [PMID: 32638392 PMCID: PMC7984395 DOI: 10.1111/ics.12648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/24/2020] [Accepted: 07/02/2020] [Indexed: 11/28/2022]
Abstract
Objective The impact of hair removal on the biophysical and biochemical characteristics of human axillary skin is not fully understood. This study investigated the effect of different hair‐removal techniques on biophysical parameters and the concentrations of key inflammatory biomarkers in the axillae of female Thai subjects. Axillary hair was removed by shaving, plucking or waxing. Methods Following a 2‐week washout phase without hair removal, subjects underwent visual assessment for erythema and skin dryness in one (randomized) axilla, then, hair was removed from the axilla by shaving, plucking or waxing according to each subject’s established habit. Erythema and dryness were assessed again 30 min after hair removal, and buffer scrubs collected from depilated and non‐depilated axillae and analysed for inflammatory cytokines; after a further 48 h, erythema, dryness and post‐inflammatory hyperpigmentation (PIHP) were assessed in the depilated axilla. Biophysical assessments (skin hydration, barrier integrity, elasticity and roughness) were made in depilated and non‐depilated axillae. Results All three hair‐removal techniques induced an increase in axillary erythema and skin dryness. Shaving was associated with significantly less erythema (P < 0.01), but significantly greater skin dryness (P < 0.05) versus the other techniques 30 min after hair removal. There were no between‐technique differences in PIHP or biophysical parameters. Interleukins IL‐1α and IL‐1RA concentrations increased, and IL‐8 concentration decreased following hair removal by each technique. Conclusion This is the first study to identify the principal cytokines associated with the inflammatory process triggered by axillary hair removal. A single hair‐removal treatment did not appear to induce PIHP or further biophysical changes to the skin.
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Affiliation(s)
- R L Evans
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
| | - S Bates
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
| | - R E Marriott
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
| | - D S Arnold
- Unilever Research & Development, Port Sunlight Laboratory, Quarry Road East, Bebington, Wirral, Merseyside, CH63 3JW, UK
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Kleivdal H, Kristiansen SI, Nilsen MV, Goksyr A, Briggs L, Holland P, McNabb P, Aasheim A, Aune T, Bates S, Bavington C, Caron D, Doucette G, Gago-Martinez A, Gallacer S, Grieve M, Haley S, Hess P, Hughes P, Léger C, Macaillou-Le Baut C, Myrland C, Neil T, Nguyen L, Ross K, Samdal I, Schaffner R, Smith E, Sosa S, Towers N, Tubaro A, Vaquero E, Wells M, Werner M, White P. Determination of Domoic Acid Toxins in Shellfish by Biosense ASP ELISAA Direct Competitive Enzyme-Linked Immunosorbent Assay: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/90.4.1011] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A collaborative study was conducted on the Biosense amnesic shellfish poisoning (ASP) enzyme-linked immunosorbent assay (ELISA) for the determination of domoic acid (DA) toxins in shellfish in order to obtain interlaboratory validation data for the method. In addition, a method comparison study was performed to evaluate the ASP ELISA as an alternative to the current liquid chromatography (LC) reference method for DA determination. The study material comprised 16 shellfish samples, including blue mussels, Pacific oysters, and king scallops, spiked with contaminated mussel homogenates to contain 0.120 mg DA/kg shellfish flesh. The shellfish samples were extracted with 50% aqueous methanol, and the supernatants were directly analyzed. Sixteen participating laboratories in 10 countries reported data from the ASP ELISA, and 4 of these laboratories also reported data from instrumental LC analysis. The participating laboratories achieved interlaboratory precision estimates for the 8 Youden paired shellfish samples in the range of 1020% for RSDr (mean 14.8 4%), and 1329% for RSDR (mean 22.7 6%). The precision estimates for the ELISA data did not show a strong dependence on the DA concentration in the study samples, and the overall precision achieved was within the acceptable range of the Horwitz guideline with HorRat values ranging from 1.1 to 2.4 (mean HorRat 1.7 0.5). The analysis of shellfish samples spiked with certified reference material (CRM)-ASP-MUS-b gave recoveries in the range of 88122%, with an average recovery of 104 10%. The estimate on method accuracy was supported by a correlation slope of 1.015 (R2 = 0.992) for the determined versus the expected DA values. Furthermore, the correlation of the ASP ELISA results with those for the instrumental LC analyses of the same sample extracts gave a correlation slope of 1.29 (R2 = 0.984). This indicates some overestimation of DA levels in shellfish by the ELISA, but it is also a result of apparent low recoveries for the LC methods. This interlaboratory study demonstrates that the ASP ELISA is suitable for the routine determination and monitoring of DA toxins in shellfish, and that it offers a rapid and cost-effective methodology with high sample throughput.
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Affiliation(s)
- Hans Kleivdal
- Biosense Laboratories AS, HIB-Thormhlensgate 55, NO-5008 Bergen, Norway
| | | | - Mona V Nilsen
- Biosense Laboratories AS, HIB-Thormhlensgate 55, NO-5008 Bergen, Norway
| | - Anders Goksyr
- Biosense Laboratories AS, HIB-Thormhlensgate 55, NO-5008 Bergen, Norway
| | - Lyn Briggs
- AgResearch Ltd, Ruakura, East St, Hamilton, New Zealand
| | | | - Paul McNabb
- Cawthron Institute, 98 Halifax St East, Nelson, New Zealand
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6
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Shulman M, Cuthbertson B, Wijeysundera D, Pearse R, Thompson B, Torres E, Ambosta A, Wallace S, Farrington C, Myles P, Wallace S, Thompson B, Ellis M, Borg B, Kerridge R, Douglas J, Brannan J, Pretto J, Godsall M, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter T, Macklin S, Elliott A, Carrera A, Terblanche N, Pitt S, Samuels J, Wilde C, MacCormick A, Leslie K, Bramley D, Southcott A, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney C, Choi S, Somascanthan P, Flores K, Beattie W, Karkouti K, Clarke H, Jerath A, McCluskey S, Wasowicz M, Granton J, Day L, Pazmino-Canizares J, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, Mcallister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G, Melo M, Mamdani M, Hillis G, Wijeysundera H. Using the 6-minute walk test to predict disability-free survival after major surgery. Br J Anaesth 2019; 122:111-119. [DOI: 10.1016/j.bja.2018.08.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/13/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022] Open
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Bates S, Li A. Quality of Life Outcomes in a Cohort of Women Undergoing Surgical Oophorectomy for the Treatment of Medical Oophorectomy-Responsive Chronic Pelvic Pain. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Reeves T, Bates S, Sharp T, Richardson K, Bali S, Plumb J, Anderson H, Prentis J, Swart M, Levett DZH. Correction to: Cardiopulmonary exercise testing (CPET) in the United Kingdom-a national survey of the structure, conduct, interpretation and funding. Perioper Med (Lond) 2018; 7:8. [PMID: 29757298 PMCID: PMC5934859 DOI: 10.1186/s13741-018-0087-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 11/16/2022] Open
Affiliation(s)
- T Reeves
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bates
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Sharp
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - K Richardson
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bali
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Plumb
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Anderson
- 4Department of Anaesthesia and Critical Care Medicine, Plymouth Hospitals NHS trust Hospital, Plymouth, UK
| | - J Prentis
- 5Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,6Departments of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK
| | - M Swart
- 7Department of Anaesthesia and Critical Care Medicine, Torbay Hospital, Torquay, UK
| | - D Z H Levett
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Polmear CM, Nathan H, Bates S, French C, Odisho J, Skinner E, Karahalios A, McGain F. The effect of intensive care unit admission on smokers' attitudes and their likelihood of quitting smoking. Anaesth Intensive Care 2018; 45:720-726. [PMID: 29137583 DOI: 10.1177/0310057x1704500612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post-ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent. A purpose-designed questionnaire which included the Fagerstrom test for nicotine dependence and evaluation of patients' attitude towards smoking cessation was completed by participants following ICU discharge and prior to hospital discharge. Participants were re-interviewed over the phone at six months post-ICU discharge. Of the 1,062 patients admitted to ICU, 253 (23%) were current smokers and 100 were enrolled. Six months post-ICU discharge, 28 (33%) of the 86 participants who were alive and contactable had quit smoking and 35 (41%) had reduced smoking. The median number of reported cigarettes smoked per day reduced by 40%. Participants who initially believed their ICU admission was smoking-related were more likely to have quit six months post-ICU discharge (odds ratio 2.98; 95% confidence interval 1.07 to 8.26; <i>P</i>=0.036). Six months post-ICU discharge, 63/86 (74%) of participants had quit or reduced their smoking. Further research into targeted smoking cessation counselling for ICU survivors is indicated.
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Affiliation(s)
| | | | | | | | | | | | - A Karahalios
- Research Fellow, Biostatistics Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria
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Turan N, Edwards MJ, Bates S, Shaw D, Chung KF, Loza MJ, James A, Van Oosterhout A. IL-6 pathway upregulation in subgroup of severe asthma is associated with neutrophilia and poor lung function. Clin Exp Allergy 2018; 48:475-478. [PMID: 29315928 DOI: 10.1111/cea.13085] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- N Turan
- GlaxoSmithKline, Respiratory R&D, Stevenage, UK
| | - M J Edwards
- GlaxoSmithKline, Respiratory R&D, Stevenage, UK
| | - S Bates
- GlaxoSmithKline, Respiratory R&D, Stevenage, UK
| | - D Shaw
- Respiratory Research Unit, University of Nottingham, Nottingham, UK
| | - K F Chung
- National Heart & Lung Institute, Imperial College, London, UK
| | - M J Loza
- Janssen Research & Development, Spring House, PA, USA
| | - A James
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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11
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Reeves T, Bates S, Sharp T, Richardson K, Bali S, Plumb J, Anderson H, Prentis J, Swart M, Levett DZH. Cardiopulmonary exercise testing (CPET) in the United Kingdom-a national survey of the structure, conduct, interpretation and funding. Perioper Med (Lond) 2018; 7:2. [PMID: 29423173 PMCID: PMC5787286 DOI: 10.1186/s13741-017-0082-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/26/2017] [Indexed: 12/13/2022] Open
Abstract
Background Cardiopulmonary exercise testing (CPET) is an exercise stress test with concomitant expired gas analysis that provides an objective, non-invasive measure of functional capacity under stress. CPET-derived variables predict postoperative morbidity and mortality after major abdominal and thoracic surgery. Two previous surveys have reported increasing utilisation of CPET preoperatively in England. We aimed to evaluate current CPET practice in the UK, to identify who performs CPET, how it is performed, how the data generated are used and the funding models. Methods All anaesthetic departments in trusts with adult elective surgery in the UK were contacted by telephone to obtain contacts for their pre-assessment and CPET service leads. An online survey was sent to all leads between November 2016 and March 2017. Results The response rate to the online survey was 73.1% (144/197) with 68.1% (98/144) reporting an established clinical service and 3.5% (5/144) setting up a service. Approximately 30,000 tests are performed a year with 93.0% (80/86) using cycle ergometry. Colorectal surgical patients are the most frequently tested (89.5%, 77/86). The majority of tests are performed and interpreted by anaesthetists. There is variability in the methods of interpretation and reporting of CPET and limited external validation of results. Conclusions This survey has identified the continued expansion of perioperative CPET services in the UK which have doubled since 2011. The vast majority of CPET tests are performed and reported by anaesthetists. It has highlighted variation in practice and a lack of standardised reporting implying a need for practice guidelines and standardised training to ensure high-quality data to inform perioperative decision making.
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Affiliation(s)
- T Reeves
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bates
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Sharp
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - K Richardson
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Bali
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Plumb
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Anderson
- 4Department of Anaesthesia and Critical Care Medicine, Plymouth Hospitals NHS trust Hospital, Plymouth, UK
| | - J Prentis
- 5Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,6Departments of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK
| | - M Swart
- 7Department of Anaesthesia and Critical Care Medicine, Torbay Hospital, Torquay, UK
| | - D Z H Levett
- 1Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,2Critical Care Research Area, National Institute for Health Research Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,3Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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12
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Johannes JW, Bates S, Beigie C, Belmonte MA, Breen J, Cao S, Centrella PA, Clark MA, Cuozzo JW, Dumelin CE, Ferguson AD, Habeshian S, Hargreaves D, Joubran C, Kazmirski S, Keefe AD, Lamb ML, Lan H, Li Y, Ma H, Mlynarski S, Packer MJ, Rawlins PB, Robbins DW, Shen H, Sigel EA, Soutter HH, Su N, Troast DM, Wang H, Wickson KF, Wu C, Zhang Y, Zhao Q, Zheng X, Hird AW. Correction to "Structure Based Design of Non-Natural Peptidic Macrocyclic Mcl-1 Inhibitors". ACS Med Chem Lett 2017; 8:1204. [PMID: 29152055 DOI: 10.1021/acsmedchemlett.7b00397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
[This corrects the article DOI: 10.1021/acsmedchemlett.6b00464.].
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13
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Stolper DA, Love GD, Bates S, Lyons TW, Young E, Sessions AL, Grotzinger JP. Paleoecology and paleoceanography of the Athel silicilyte, Ediacaran-Cambrian boundary, Sultanate of Oman. Geobiology 2017; 15:401-426. [PMID: 28387009 DOI: 10.1111/gbi.12236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 02/27/2017] [Indexed: 05/22/2023]
Abstract
The Athel silicilyte is an enigmatic, hundreds of meters thick, finely laminated quartz deposit, in which silica precipitated in deep water (>~100-200 m) at the Ediacaran-Cambrian boundary in the South Oman Salt Basin. In contrast, Meso-Neoproterozoic sinks for marine silica were dominantly restricted to peritidal settings. The silicilyte is known to contain sterane biomarkers for demosponges, which today are benthic, obligately aerobic organisms. However, the basin has previously been described as permanently sulfidic and time-equivalent shallow-water carbonate platform and evaporitic facies lack silica. The Athel silicilyte thus represents a unique and poorly understood depositional system with implications for late Ediacaran marine chemistry and paleoecology. To address these issues, we made petrographic observations, analyzed biomarkers in the solvent-extractable bitumen, and measured whole-rock iron speciation and oxygen and silicon isotopes. These data indicate that the silicilyte is a distinct rock type both in its sedimentology and geochemistry and in the original biology present as compared to other facies from the same time period in Oman. The depositional environment of the silicilyte, as compared to the bounding shales, appears to have been more reducing at depth in sediments and possibly bottom waters with a significantly different biological community contributing to the preserved biomarkers. We propose a conceptual model for this system in which deeper, nutrient-rich waters mixed with surface seawater via episodic mixing, which stimulated primary production. The silica nucleated on this organic matter and then sank to the seafloor, forming the silicilyte in a sediment-starved system. We propose that the silicilyte may represent a type of environment that existed elsewhere during the Neoproterozoic. These environments may have represented an important locus for silica removal from the oceans.
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Affiliation(s)
- D A Stolper
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - G D Love
- Department of Earth Sciences, University of California, Riverside, CA, USA
| | - S Bates
- Department of Earth Sciences, University of California, Riverside, CA, USA
| | - T W Lyons
- Department of Earth Sciences, University of California, Riverside, CA, USA
| | - E Young
- Department of Earth and Space Sciences, University of California, Los Angeles, CA, USA
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, CA, USA
| | - A L Sessions
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - J P Grotzinger
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
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14
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Johannes JW, Bates S, Beigie C, Belmonte MA, Breen J, Cao S, Centrella PA, Clark MA, Cuozzo JW, Dumelin CE, Ferguson AD, Habeshian S, Hargreaves D, Joubran C, Kazmirski S, Keefe AD, Lamb ML, Lan H, Li Y, Ma H, Mlynarski S, Packer MJ, Rawlins PB, Robbins DW, Shen H, Sigel EA, Soutter HH, Su N, Troast DM, Wang H, Wickson KF, Wu C, Zhang Y, Zhao Q, Zheng X, Hird AW. Structure Based Design of Non-Natural Peptidic Macrocyclic Mcl-1 Inhibitors. ACS Med Chem Lett 2016; 8:239-244. [PMID: 28197319 DOI: 10.1021/acsmedchemlett.6b00464] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 12/27/2016] [Indexed: 12/22/2022] Open
Abstract
Mcl-1 is a pro-apoptotic BH3 protein family member similar to Bcl-2 and Bcl-xL. Overexpression of Mcl-1 is often seen in various tumors and allows cancer cells to evade apoptosis. Here we report the discovery and optimization of a series of non-natural peptide Mcl-1 inhibitors. Screening of DNA-encoded libraries resulted in hit compound 1, a 1.5 μM Mcl-1 inhibitor. A subsequent crystal structure demonstrated that compound 1 bound to Mcl-1 in a β-turn conformation, such that the two ends of the peptide were close together. This proximity allowed for the linking of the two ends of the peptide to form a macrocycle. Macrocyclization resulted in an approximately 10-fold improvement in binding potency. Further exploration of a key hydrophobic interaction with Mcl-1 protein and also with the moiety that engages Arg256 led to additional potency improvements. The use of protein-ligand crystal structures and binding kinetics contributed to the design and understanding of the potency gains. Optimized compound 26 is a <3 nM Mcl-1 inhibitor, while inhibiting Bcl-2 at only 5 μM and Bcl-xL at >99 μM, and induces cleaved caspase-3 in MV4-11 cells with an IC50 of 3 μM after 6 h.
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Affiliation(s)
- Jeffrey W. Johannes
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Stephanie Bates
- AstraZeneca R&D Cambridge Science Park, Unit 310 Darwin Building, Cambridge CB4 0WG, United Kingdom
| | - Carl Beigie
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Matthew A. Belmonte
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - John Breen
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Shenggen Cao
- Pharmaron Beijing Co., Ltd. 6 Taihe Road BDA, Beijing 100176 P. R. China
| | - Paolo A. Centrella
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Matthew A. Clark
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - John W. Cuozzo
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Christoph E. Dumelin
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Andrew D. Ferguson
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Sevan Habeshian
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - David Hargreaves
- AstraZeneca R&D Cambridge Science Park, Unit 310 Darwin Building, Cambridge CB4 0WG, United Kingdom
| | - Camil Joubran
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Steven Kazmirski
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Anthony D. Keefe
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Michelle L. Lamb
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Haiye Lan
- Pharmaron Beijing Co., Ltd. 6 Taihe Road BDA, Beijing 100176 P. R. China
| | - Yunxia Li
- Pharmaron Beijing Co., Ltd. 6 Taihe Road BDA, Beijing 100176 P. R. China
| | - Hao Ma
- Pharmaron Beijing Co., Ltd. 6 Taihe Road BDA, Beijing 100176 P. R. China
| | - Scott Mlynarski
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Martin J. Packer
- AstraZeneca R&D Alderley Park, Macclesfield, Cheshire SK10 4TG, United Kingdom
| | - Philip B. Rawlins
- AstraZeneca R&D Cambridge Science Park, Unit 310 Darwin Building, Cambridge CB4 0WG, United Kingdom
| | - Daniel W. Robbins
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Haidong Shen
- Pharmaron Beijing Co., Ltd. 6 Taihe Road BDA, Beijing 100176 P. R. China
| | - Eric A. Sigel
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Holly H. Soutter
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Nancy Su
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Dawn M. Troast
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Haiyun Wang
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Kate F. Wickson
- AstraZeneca R&D Cambridge Science Park, Unit 310 Darwin Building, Cambridge CB4 0WG, United Kingdom
| | - Chengyan Wu
- Pharmaron Beijing Co., Ltd. 6 Taihe Road BDA, Beijing 100176 P. R. China
| | - Ying Zhang
- X-Chem Pharmaceuticals, 100 Beaver Street, Waltham, Massachusetts 02453, United States
| | - Qiuying Zhao
- Pharmaron Beijing Co., Ltd. 6 Taihe Road BDA, Beijing 100176 P. R. China
| | - Xiaolan Zheng
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
| | - Alexander W. Hird
- AstraZeneca R&D Boston, 35 Gatehouse Drive, Waltham, Massachusetts 02451, United States
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Takach Lapner S, Julian JA, Linkins LA, Bates S, Kearon C. Questioning the use of an age-adjusted D-dimer threshold to exclude venous thromboembolism: analysis of individual patient data from two diagnostic studies: reply. J Thromb Haemost 2016; 14:2555-2556. [PMID: 27661781 DOI: 10.1111/jth.13512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S Takach Lapner
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - J A Julian
- Ontario Clinical Oncology Group, Juravinski Hospital, Hamilton, ON, Canada
| | - L-A Linkins
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
| | - S Bates
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
| | - C Kearon
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada
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Moore P, Miley J, Bates S. New Uses For Highly Miscible Liquid Polymeric Colorants in the Manufacture of Colored Urethane Systems. J CELL PLAST 2016. [DOI: 10.1177/0021955x8301900403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- P.D. Moore
- Milliken Chemical PO Box 1927 Spartanburg, SC 29304
| | - J.W. Miley
- Milliken Chemical PO Box 1927 Spartanburg, SC 29304
| | - S. Bates
- Milliken Chemical PO Box 1927 Spartanburg, SC 29304
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Abstract
The National Health Service (NHS) cervical-screening programme has recently produced guidelines specifically for HIV-positive women. This includes annual cervical cytology screening and colposcopy to follow national guidelines. The case notes of all women attending Sheffield genitourinary clinic were audited. Of the 46 notes available, there was no documentation that annual screening has been offered in 26, and 10% of women did not have appropriate management of an abnormal smear. Information on the cytology form could result in a breach in confidentiality in cases where general practitioners are not aware of a patient's HIV status.
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Affiliation(s)
- E J Morris
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK
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Tang SC, Bates S, Kesari S, Brenner AJ, Anders CK, Garcia A, Ibrahim NK, Tkaczuk KHR, Kumthekar P. Abstract P6-17-04: A phase II, open-label, multi-center study of ANG1005, a novel brain-penetrant taxane derivative, in breast cancer patients with recurrent CNS metastases. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-17-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Treatment options for brain metastases are limited to local therapies due to the inability of most anti-cancer agents to cross the blood brain barrier (BBB). ANG1005 is a novel taxane derivative, being developed for targeted treatment of brain metastases. It consists of 3 paclitaxel molecules covalently linked to Angiopep-2 designed to cross the BBB and to penetrate malignant cells, regardless of location, via the low density lipoprotein (LDL) receptor related protein-1 (LRP-1) transport system.
Methods: Adult patients with measurable recurrent brain metastases from breast cancer with, or without, leptomeningeal disease are currently being enrolled in this multi-center, open-label study (planned n=56). ANG1005 is administered IV at 600 mg/m2 every three weeks (one cycle) until disease progression, unacceptable toxicity or consent withdrawal. HER2+ patients are allowed to continue HER2 targeted therapies. The primary endpoint is intracranial objective response rate, as assessed by MRI using CNS RECIST 1.1. Secondary endpoints include duration of intracranial response, median progression-free survival, 3/6/12-month progression-free survival rate, overall survival at 6 months, extracranial objective response rate, safety and tolerability. Extracranial response is also assessed by CT using RECIST 1.1. An imaging sub-study, evaluating the use of 18F-FLT-PET in comparison to MRI, is also ongoing in 10 patients with measurable brain metastases from breast cancer, receiving ANG1005 IV at 550 mg/m2.
Results: Accrual is ongoing and to date, 48 patients have been treated with a range of 1-18 cycles of ANG1005. Median age is 47 years (range: 26-65). Safety profile is similar to that of paclitaxel with myelosuppression as the predominating toxicity. Based on data from patients evaluated to date for intracranial response, 6/30 (20%) patients had a partial response (PR) and 17/30 (57%) had a stable disease (SD), as best response. A sub-analysis, based on breast cancer sub-type is presented below:
Intracranial Response by Breast Cancer SubsetOutcome by CNS RECISTHER2- (n=13)HER2+ (n=17)TNBC (n=6)LMD (n=11)PR, n (%)1 (8%)5 (29%)1 (17%)4 (36%)SD, n (%)6 (46%)10 (59%)2 (33%)5 (45%)PD, n (%)6 (46%)2 (12%)3 (50%)2 (18%)TNBC, triple-negative breast cancer, a sub-group of HER2-; LMD, leptomeningeal disease, including 3 HER2- and 8 HER2+ patients
The longest duration on treatment is for 18 cycles, seen in a patient with an intracranial PR that sustained for 10 cycles; the treatment is still ongoing.
Extracranial tumor evaluations were completed in 14 patients, all showing disease control including in those previously treated with paclitaxel. One (7%) patient had a PR and 13 (93%) patients had an SD.
Conclusions: CNS activity was observed in all subsets of breast cancer, suggesting that ANG1005 is a promising therapy for treatment of brain and leptomeningeal metastases from breast cancer. ANG1005 treatment also resulted in disease control in extracranial lesions, including patients previously treated with paclitaxel. The dose and treatment regimen were well tolerated with a safety profile similar to paclitaxel. Updated efficacy and safety data will be presented at the meeting.
Citation Format: Tang S-C, Bates S, Kesari S, Brenner AJ, Anders CK, Garcia A, Ibrahim NK, Tkaczuk KHR, Kumthekar P. A phase II, open-label, multi-center study of ANG1005, a novel brain-penetrant taxane derivative, in breast cancer patients with recurrent CNS metastases. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-17-04.
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Affiliation(s)
- S-C Tang
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - S Bates
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - S Kesari
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - AJ Brenner
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - CK Anders
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - A Garcia
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - NK Ibrahim
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - KHR Tkaczuk
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
| | - P Kumthekar
- Georgia Regents University Cancer Center, Augusta, GA; National Cancer Insitute, NIH, Bethesda, MD; UC San Diego Moores Cancer Center, La Jolla, CA; Cancer Therapy and Research Center at UTHSCSA, San Antonio, TX; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of Southern California - Norris Comprehensive Cancer Center, Los Angeles, CA; M.D. Anderson Cancer Center, Houston, TX; University of Maryland Greenebaum Cancer Center, Baltimore, MD; Northwestern University, Chicago, IL
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Padro D, Eisch R, Bates S, Simone C, Ning H, Smart D, Jones J, Krauze A, Citrin D, Kesarwala A, Camphausen K, Kaushal A. Salvage Radiation Therapy for Chemotherapy Refractory Cutaneous Mycosis Fungoides. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Laser H, Hockwin O, Müller-Breitenkamp U, Dobbs R, Bates S, Strack C. Risk factor diabetes: long-term follow-up Scheimpflug slit image analysis of lens transparency of diabetic patients. Dev Ophthalmol 2015; 21:70-7. [PMID: 1868953 DOI: 10.1159/000419938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- H Laser
- Department of Experimental Ophthalmology, University of Bonn, FRG
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Mackow RC, Winchester JF, Argy WP, Andrews PM, Fields PA, Bates S, Rakowski TA, Schreiner GE. Sclerosing encapsulating peritonitis in rats: an experimental study with intraperitoneal antiseptics. Contrib Nephrol 2015; 57:213-8. [PMID: 3677695 DOI: 10.1159/000414285] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- R C Mackow
- Georgetown University Medical Center, Washington, D.C
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Bates S, Lindenberg M, Bryla C, Patronas N, Amiri-Kordestani L, Fojo T, Balasubramaniam S, Choyke P. ANG-1005 in Patients with Brain Metastases from Breast Cancer: Correlative Imaging with 18F-FLT-PET/CT. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv091.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bates S, Syrett A, Namazie A. The Effect of Trendelenburg Position and Pneumoperitoneum on Ventilation Pressures during Laparoscopic Hysterectomy: A Randomised Controlled Trial (RCT) of an Inflatable Buttock Elevator. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Foshat M, Bates S, Russo W, Huerta A, Albright K, Giddings K, Indrikovs A, Qian YW. Effect of Freezing Plasma at –20°C for 2 Weeks on Prothrombin Time, Activated Partial Thromboplastin Time, Dilute Russell Viper Venom Time, Activated Protein C Resistance, and d-Dimer Levels. Clin Appl Thromb Hemost 2014; 21:41-7. [DOI: 10.1177/1076029614535973] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To assess the impact of preanalytical variables of time and temperature on prothrombin time (PT), activated partial thromboplastin time (aPTT), dilute Russell viper venom time (DRVVT), activated protein C resistance (APCR), and d-dimer, samples from 23 healthy individuals and 18 patients having coagulopathy with known abnormal PT and aPTT were collected. Plasma from each individual was separately pooled and aliquoted; the first 2 aliquots were stored at room temperature then analyzed at 2 hours (baseline) and 4 hours postcollection. The remaining aliquots were stored at −20°C and thawed for analysis at 48 hours, 1, and 2 weeks. In both healthy participants and participants with coagulopathy, PT, aPTT, APCR, DRVVT, and D-dimer had no significant changes at 4 and 48 hours, and 1 and 2 weeks postcollection compared to baseline, or the changes were less than 10%. The results indicate PT, aPTT, DRVVT, APCR, and d-dimer can be stored for 2 weeks at −20°C without compromising clinical interpretation in both healthy individuals and individuals with coagulopathy. Increasing storage time will facilitate sample processing from off-site clinics.
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Affiliation(s)
| | | | - Wendy Russo
- University of Texas Medical Branch, Galveston, TX, USA
| | | | | | | | | | - You-wen Qian
- University of Texas Medical Branch, Galveston, TX, USA
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Amiri-Kordestani L, Mena E, Lindenberg ML, Kurdziel K, Choyke P, Patronas N, Frye R, Lin N, Bala S, Fojo T, Bates S. Abstract P4-01-09: 18F-FLT-PET/CT for the prediction of response to ANG-1005 therapy in patients with brain metastases from breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-01-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: ANG1005 (formerly called GRN1005) is a peptide-drug conjugate being developed for targeted treatment of brain metastases. It consists of 3 molecules of paclitaxel covalently linked to Angiopep-2 designed to cross the blood brain barrier (BBB) via the low density lipoprotein (LDL) receptor-related protein-1 (LRP1)-mediated trancytosis. This drug was evaluated in a multi-center, open-label single-arm study (GRABMB study). An interim analysis determined that the agent met the futility endpoint based on MRI assessment (SABC 2012). However, centrally confirmed responses were achieved in the study, and a biomarker substudy enrolling patients (pts) to evaluate the utility of FLT-PET in assessing response to treatment with ANG1005 suggested sufficient activity of the agent to allow continuation of the study. 18F-FLT (3’-Fluoro-3’ deoxythymidine)-PET imaging is a novel imaging modality which provides a tool for measuring in vivo tumor cell proliferation. FLT is an analog of thymidine; cellular retention of FLT reflects DNA synthesis.
Methods: Adult pts with measurable BMBC were eligible with or without history of prior WBRT. We compared 18F-FLT-PET/CT with MRI-gadolinium contrast images for brain metastases detection and for assessment of whether treatment with ANG1005 was associated with significant change in intracranial tumor uptake of 18F-FLT.
ANG1005 therapy was administered intravenously at 550 mg/m2 q 21d until progression of intra-cranial disease or unacceptable toxicity. All pts underwent 18F-FLT PET/CT imaging before and after 1 cycle of therapy with ANG1005. Pts were scanned dynamically over 30 min followed by a static whole body PET image at 1 hour post-injection. We calculated the% of change before and after therapy, with change > 20% considered significant.
Results: 5/10 planned pts have been accrued to the substudy to date, and 12 metastatic brain lesions have been analyzed. The maximum standard uptake value (SUVmax) ranged from 0.8 to 4.0, mean 1.8 for baseline scans. Tumor to normal brain background ratios ranged from 3.2 to 22.3, mean 9.4. 7/12 lesions showed >20% change between pre and post therapy. The average% change was (-) 42.39% ± 12.77, range: 29.2 to 66.8% (using SUVmax), and (-) 38.7% ± 14.3, range: 20.12 to 57.10% (using tumor to normal ratios). Based on brain MRI evaluation per RECIST 1.1 criteria, 1 pt had intra-cranial partial response (PR) and 3 patients had stable disease (SD). These pts remained on therapy for an average of 7 cycles, range: 5 to 9 cycles. 1 pt withdrew consent after 2 cycles of therapy and opted to receive whole brain radiation therapy. 5/42 pts achieved a confirmed investigator-assessed PR by MRI at 550 mg/m2, and 4/13 pts achieved a PR at 650 mg/m2, a dose not progressed due to toxicity.
Conclusion: This pilot study using 18F-FLT-PET imaging of brain metastases suggests that it is a promising tool for detection and measurement of CNS disease. Given that contrast-enhanced MRI detection of brain metastases represent gadolinium leakage through the BBB rather than actual tumor volume measurements, better approaches are needed to assess efficacy of therapies. Accrual to this study is ongoing. Updated results with ANG1005 will be presented during the meeting.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-01-09.
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Affiliation(s)
- L Amiri-Kordestani
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - E Mena
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - ML Lindenberg
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - K Kurdziel
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - P Choyke
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - N Patronas
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - R Frye
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - N Lin
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - S Bala
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - T Fojo
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
| | - S Bates
- National Cancer Institute, Bethesda, MD; Dana-Farber Cancer Institute, Boston, MA
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Bates S, Jonaitis D, Nail S. Sucrose lyophiles: A semi-quantitative study of residual water content by total X-ray diffraction analysis. Eur J Pharm Biopharm 2013; 85:184-8. [DOI: 10.1016/j.ejpb.2013.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/14/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
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Artac M, Dalton ARH, Babu H, Bates S, Millett C, Majeed A. Primary care and population factors associated with NHS Health Check coverage: a national cross-sectional study. J Public Health (Oxf) 2013; 35:431-9. [PMID: 23881962 DOI: 10.1093/pubmed/fdt069] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION High and equitable coverage of systematic cardiovascular disease (CVD) prevention programmes, such as the NHS Health Check programme in England, is essential if they are to effectively reduce the population CVD burden. METHODS We conducted a cross-sectional study using data from 151 English primary care trusts (PCTs) on NHS Health Check coverage during 2011-12. We examined the associations between programme coverage and primary care and population factors, including patient demographics, primary care workforce and cardiovascular health need. RESULTS Median coverage of NHS Health Checks was 8.2%, with wide PCT-level variation (range = 0-29.8%). Coverage was significantly higher in PCTs in the most deprived areas compared with the least deprived (P = 0.035), adjusting for covariates. Significant negative associations between coverage and a higher proportion of PCT population aged 40-74 years-the eligible Health Check age group, a larger total population size and higher practice staffing levels were found in the unadjusted analyses. CONCLUSIONS NHS Health Check coverage during 2011-12 was lower than the government projection of 18% coverage. Coverage must be increased through concerted multi-disciplinary strategies, for the programme to improve cardiovascular health in England. Considerable variation in participation between PCTs warrants attention, with enhanced support for poor performers.
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Affiliation(s)
- M Artac
- Department of Primary Care and Public Health, Imperial College London, London, UK.
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Thornton D, Stappers B, Bailes M, Barsdell B, Bates S, Bhat NDR, Burgay M, Burke-Spolaor S, Champion DJ, Coster P, D'Amico N, Jameson A, Johnston S, Keith M, Kramer M, Levin L, Milia S, Ng C, Possenti A, van Straten W. A Population of Fast Radio Bursts at Cosmological Distances. Science 2013; 341:53-6. [DOI: 10.1126/science.1236789] [Citation(s) in RCA: 699] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- D. Thornton
- Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
- Commonwealth Science and Industrial Research Organisation (CSIRO) Astronomy and Space Science, Australia Telescope National Facility, Post Office Box 76, Epping, NSW 1710, Australia
| | - B. Stappers
- Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
| | - M. Bailes
- Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
- Australian Research Council Centre of Excellence for All-Sky Astrophysics (CAASTRO), Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
| | - B. Barsdell
- Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
- Australian Research Council Centre of Excellence for All-Sky Astrophysics (CAASTRO), Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
| | - S. Bates
- West Virginia University Center for Astrophysics, West Virginia University, Morgantown, WV 26506, USA
| | - N. D. R. Bhat
- Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
- Australian Research Council Centre of Excellence for All-Sky Astrophysics (CAASTRO), Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
- International Centre for Radio Astronomy Research, Department of Imaging and Applied Physics, Faculty of Science and Engineering, Curtin University, Post Office Box U1987, Perth, WA 6845, Australia
| | - M. Burgay
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Loc. Poggio dei Pini, Strada 54, 09012 Capoterra (CA), Italy
| | - S. Burke-Spolaor
- Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91104, USA
| | - D. J. Champion
- Max-Planck-Institut für Radio Astronomie, Auf dem Hugel 69, 53121 Bonn, Germany
| | - P. Coster
- Commonwealth Science and Industrial Research Organisation (CSIRO) Astronomy and Space Science, Australia Telescope National Facility, Post Office Box 76, Epping, NSW 1710, Australia
- Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
| | - N. D'Amico
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Loc. Poggio dei Pini, Strada 54, 09012 Capoterra (CA), Italy
- Dipartimento di Fisica, Universita di Cagliari, Cittadella Universitaria 09042, Monserrato (CA), Italy
| | - A. Jameson
- Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
- Australian Research Council Centre of Excellence for All-Sky Astrophysics (CAASTRO), Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
| | - S. Johnston
- Commonwealth Science and Industrial Research Organisation (CSIRO) Astronomy and Space Science, Australia Telescope National Facility, Post Office Box 76, Epping, NSW 1710, Australia
| | - M. Keith
- Commonwealth Science and Industrial Research Organisation (CSIRO) Astronomy and Space Science, Australia Telescope National Facility, Post Office Box 76, Epping, NSW 1710, Australia
| | - M. Kramer
- Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
- Max-Planck-Institut für Radio Astronomie, Auf dem Hugel 69, 53121 Bonn, Germany
| | - L. Levin
- West Virginia University Center for Astrophysics, West Virginia University, Morgantown, WV 26506, USA
| | - S. Milia
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Loc. Poggio dei Pini, Strada 54, 09012 Capoterra (CA), Italy
| | - C. Ng
- Max-Planck-Institut für Radio Astronomie, Auf dem Hugel 69, 53121 Bonn, Germany
| | - A. Possenti
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Cagliari, Loc. Poggio dei Pini, Strada 54, 09012 Capoterra (CA), Italy
| | - W. van Straten
- Centre for Astrophysics and Supercomputing, Swinburne University of Technology, Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
- Australian Research Council Centre of Excellence for All-Sky Astrophysics (CAASTRO), Mail H30, Post Office Box 218, Hawthorn, VIC 3122, Australia
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Akilov OE, Grant C, Frye R, Bates S, Piekarz R, Geskin LJ. Low-dose electron beam radiation and romidepsin therapy for symptomatic cutaneous T-cell lymphoma lesions. Br J Dermatol 2012; 167:194-7. [PMID: 22372971 PMCID: PMC3386371 DOI: 10.1111/j.1365-2133.2012.10905.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Romidepsin is a structurally unique histone deacetylase inhibitor approved by the U.S. Food and Drug Administration for therapy of relapsed or refractory cutaneous T-cell lymphoma (CTCL). Localized electron beam radiation therapy (LEBT) is standard practice in the care of patients with chronically traumatized and painful lesions. Combination therapy of those two modalities may be beneficial for the therapy of CTCL. OBJECTIVES To report observations on supportive LEBT utilized for isolated refractory lesions in patients on romidepsin. METHODS Observations were made during a phase II clinical trial sponsored by the National Cancer Institute (NCI-1312) examining the efficacy of romidepsin for patients with relapsed, refractory or advanced CTCL, stage IB-IVA mycosis fungoides (MF) or Sézary syndrome. Skin responses were assessed by evaluation of five target lesions only. Patients with objective clinical responses in target lesions who had symptomatic nontarget lesions were allowed limited LEBT to isolated lesions for symptomatic relief. Patients who received localized radiation were not considered complete responders at any point. RESULTS Five patients with advanced MF (three stage IIB and two stage IVA2) received LEBT to symptomatic nontarget lesions while on a protocol with romidepsin. None of these patients experienced additional or unexpected toxicity. Four of the five patients demonstrated fast and durable responses. We noted that significantly lower than standard doses of LEBT effectively treated symptomatic lesions in these patients. CONCLUSIONS LEBT demonstrated significant responses at very low doses without additional toxicity in patients on protocol treatment with the histone deacetylase inhibitor romidepsin. This merits formal investigation in a clinical trial for potential synergy in patients with CTCL.
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Affiliation(s)
- O E Akilov
- Department of Dermatology, University of Pittsburgh, 200 Lothrop Street, Presby South Tower, Suite 3880, Pittsburgh, PA 15213, USA
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Abstract
UNLABELLED This study was undertaken to improve the performance of a Chemotherapy Treatment Unit by increasing the throughput and reducing the average patient's waiting time. In order to achieve this objective, a scheduling template has been built. The scheduling template is a simple tool that can be used to schedule patients' arrival to the clinic. A simulation model of this system was built and several scenarios, that target match the arrival pattern of the patients and resources availability, were designed and evaluated. After performing detailed analysis, one scenario provide the best system's performance. A scheduling template has been developed based on this scenario. After implementing the new scheduling template, 22.5% more patients can be served. 1. INTRODUCTION CancerCare Manitoba is a provincially mandated cancer care agency. It is dedicated to provide quality care to those who have been diagnosed and are living with cancer. MacCharles Chemotherapy unit is specially built to provide chemotherapy treatment to the cancer patients of Winnipeg. In order to maintain an excellent service, it tries to ensure that patients get their treatment in a timely manner. It is challenging to maintain that goal because of the lack of a proper roster, the workload distribution and inefficient resource allotment. In order to maintain the satisfaction of the patients and the healthcare providers, by serving the maximum number of patients in a timely manner, it is necessary to develop an efficient scheduling template that matches the required demand with the availability of resources. This goal can be reached using simulation modelling. Simulation has proven to be an excellent modelling tool. It can be defined as building computer models that represent real world or hypothetical systems, and hence experimenting with these models to study system behaviour under different scenarios.1, 2 A study was undertaken at the Children's Hospital of Eastern Ontario to identify the issues behind the long waiting time of a emergency room.3 A 20---day field observation revealed that the availability of the staff physician and interaction affects the patient wait time. Jyväskylä et al.4 used simulation to test different process scenarios, allocate resources and perform activity---based cost analysis in the Emergency Department (ED) at the Central Hospital. The simulation also supported the study of a new operational method, named "triage-team" method without interrupting the main system. The proposed triage team method categorises the entire patient according to the urgency to see the doctor and allows the patient to complete the necessary test before being seen by the doctor for the first time. The simulation study showed that it will decrease the throughput time of the patient and reduce the utilisation of the specialist and enable the ordering all the tests the patient needs right after arrival, thus quickening the referral to treatment. Santibáñez et al.5 developed a discrete event simulation model of British Columbia Cancer Agency"s ambulatory care unit which was used to study the impact of scenarios considering different operational factors (delay in starting clinic), appointment schedule (appointment order, appointment adjustment, add---ons to the schedule) and resource allocation. It was found that the best outcomes were obtained when not one but multiple changes were implemented simultaneously. Sepúlveda et al.6 studied the M. D. Anderson Cancer Centre Orlando, which is a cancer treatment facility and built a simulation model to analyse and improve flow process and increase capacity in the main facility. Different scenarios were considered like, transferring laboratory and pharmacy areas, adding an extra blood draw room and applying different scheduling techniques of patients. The study shows that by increasing the number of short---term (four hours or less) patients in the morning could increase chair utilisation. Discrete event simulation also helps improve a service where staff are ignorant about the behaviour of the system as a whole; which can also be described as a real professional system. Niranjon et al.7 used simulation successfully where they had to face such constraints and lack of accessible data. Carlos et al. 8 used Total quality management and simulation - animation to improve the quality of the emergency room. Simulation was used to cover the key point of the emergency room and animation was used to indicate the areas of opportunity required. This study revealed that a long waiting time, overload personnel and increasing withdrawal rate of patients are caused by the lack of capacity in the emergency room. Baesler et al.9 developed a methodology for a cancer treatment facility to find stochastically a global optimum point for the control variables. A simulation model generated the output using a goal programming framework for all the objectives involved in the analysis. Later a genetic algorithm was responsible for performing the search for an improved solution. The control variables that were considered in this research are number of treatment chairs, number of drawing blood nurses, laboratory personnel, and pharmacy personnel. Guo et al. 10 presented a simulation framework considering demand for appointment, patient flow logic, distribution of resources, scheduling rules followed by the scheduler. The objective of the study was to develop a scheduling rule which will ensure that 95% of all the appointment requests should be seen within one week after the request is made to increase the level of patient satisfaction and balance the schedule of each doctor to maintain a fine harmony between "busy clinic" and "quiet clinic". Huschka et al.11 studied a healthcare system which was about to change their facility layout. In this case a simulation model study helped them to design a new healthcare practice by evaluating the change in layout before implementation. Historical data like the arrival rate of the patients, number of patients visited each day, patient flow logic, was used to build the current system model. Later, different scenarios were designed which measured the changes in the current layout and performance. Wijewickrama et al.12 developed a simulation model to evaluate appointment schedule (AS) for second time consultations and patient appointment sequence (PSEQ) in a multi---facility system. Five different appointment rule (ARULE) were considered: i) Baily; ii) 3Baily; iii) Individual (Ind); iv) two patients at a time (2AtaTime); v) Variable Interval and (V---I) rule. PSEQ is based on type of patients: Appointment patients (APs) and new patients (NPs). The different PSEQ that were studied in this study were: i) first--- come first---serve; ii) appointment patient at the beginning of the clinic (APBEG); iii) new patient at the beginning of the clinic (NPBEG); iv) assigning appointed and new patients in an alternating manner (ALTER); v) assigning a new patient after every five---appointment patients. Also patient no show (0% and 5%) and patient punctuality (PUNCT) (on---time and 10 minutes early) were also considered. The study found that ALTER---Ind. and ALTER5---Ind. performed best on 0% NOSHOW, on---time PUNCT and 5% NOSHOW, on---time PUNCT situation to reduce WT and IT per patient. As NOSHOW created slack time for waiting patients, their WT tends to reduce while IT increases due to unexpected cancellation. Earliness increases congestion whichin turn increases waiting time. Ramis et al.13 conducted a study of a Medical Imaging Center (MIC) to build a simulation model which was used to improve the patient journey through an imaging centre by reducing the wait time and making better use of the resources. The simulation model also used a Graphic User Interface (GUI) to provide the parameters of the centre, such as arrival rates, distances, processing times, resources and schedule. The simulation was used to measure the waiting time of the patients in different case scenarios. The study found that assigning a common function to the resource personnel could improve the waiting time of the patients. The objective of this study is to develop an efficient scheduling template that maximises the number of served patients and minimises the average patient's waiting time at the given resources availability. To accomplish this objective, we will build a simulation model which mimics the working conditions of the clinic. Then we will suggest different scenarios of matching the arrival pattern of the patients with the availability of the resources. Full experiments will be performed to evaluate these scenarios. Hence, a simple and practical scheduling template will be built based on the indentified best scenario. The developed simulation model is described in section 2, which consists of a description of the treatment room, and a description of the types of patients and treatment durations. In section 3, different improvement scenarios are described and their analysis is presented in section 4. Section 5 illustrates a scheduling template based on one of the improvement scenarios. Finally, the conclusion and future direction of our work is exhibited in section 6. 2. SIMULATION MODEL A simulation model represents the actual system and assists in visualising and evaluating the performance of the system under different scenarios without interrupting the actual system. Building a proper simulation model of a system consists of the following steps. Observing the system to understand the flow of the entities, key players, availability of resources and overall generic framework.Collecting the data on the number and type of entities, time consumed by the entities at each step of their journey, and availability of resources.After building the simulation model it is necessary to confirm that the model is valid. (ABSTRACT TRUNCATED)
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Affiliation(s)
- Z Ahmed
- Department of Mechanical and Manufacturing Engineering, University of Manitoba , Winnipeg, Manitoba, Canada
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McCarty EJ, O'Mahony C, Bates S, Fox P, Maw RD. Assessing the understanding and prior uptake of human papillomavirus vaccination among eligible females attending genitourinary medicine clinics in UK. Br J Vener Dis 2011; 87:488. [DOI: 10.1136/sextrans-2011-050142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Briggs A, Partridge DG, Bates S. HIV testing in colposcopy and termination of pregnancy services: a missed opportunity? Journal of Family Planning and Reproductive Health Care 2011; 37:201-3. [DOI: 10.1136/jfprhc-2011-100106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Demierre M, Whittaker S, Kim Y, Kim E, Piekarz R, Prince M, Nichols J, Balser J, Prentice A, Bates S. Pooled analyses of two international, multicenter clinical studies of romidepsin in 167 patients with cutaneous T-cell lymphoma (CTCL). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8546] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8546 Background: Romidepsin is a novel pan-HDAC inhibitor with demonstrated single-agent activity in 2 open-label clinical studies of 167 patients (pts) with CTCL [mycosis fungoides or Sézary Syndrome (SS)]. Data for these 2 studies were pooled for more accurate estimates of endpoints and investigation of subpopulations. Methods: GPI-04–0001 (pivotal study) enrolled 96 pts with confirmed CTCL who had recieved ≥1 prior systemic therapy. NCI 1312 (supportive study) enrolled 71 pts with CTCL. Pts recieved romidepsin, 14mg/m2 as a 4-hr infusion on days 1, 8, and 15 every 28 days until disease progression (≥25% increase). The primary efficacy endpoint for both studies was overall response rate (ORR) using a composite endpoint that included skin assessment, lymph node and visceral involvement and abnormal circulating T-cells/Sézary cells. Results: 167 pts received romidepsin (as-treated); 135 pts (81%) were in the efficacy evaluable population. Mean age was 57±12 yrs, 67% men, 87% white. 103 pts (76%) had stage ≥IIB disease. Median number of prior systemic therapies was 2 (range 1–8). ORR in the table. Responses were noted in: 42% of pts with stage ≥IIB; 11 (58%) of 19 pts with SS (erythroderma + Sézary cells, >1000/ml or >20% ); and 20 (38%) of 52 pts who received prior bexarotene and 8 (40%) of 20 pts who had received denileukin diftitox. Most common drug-related adverse events (AE), all grades, included: nausea (67%), fatigue (49%), anorexia (37%), ECG T-wave changes (29%), anemia (26%), dysgeusia (23%), neutropenia (22%), leucopenia (20%). Related serious AEs in 2% of pts: supraventicular arrhythmia, ventricular arrhythmia, infection, neutropenia, WBC decreased, hyperuricemia, hypotension; all other serious AEs in ≤1 pt. 3 deaths reported as possibly related. Conclusions: Romidepsin is a valuable new therapy for pts with CTCL based on the ORR, CR, durability of response, improvement in all disease compartments and responses at all stages and in all subpopulations analyzed. [Table: see text] [Table: see text]
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Affiliation(s)
- M. Demierre
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - S. Whittaker
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - Y. Kim
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - E. Kim
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - R. Piekarz
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - M. Prince
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - J. Nichols
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - J. Balser
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - A. Prentice
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
| | - S. Bates
- Boston Medical Center, Boston, MA; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; University of Pennsylvania Health System, Philadelphia, PA; National Cancer Institute, Bethesda, MA; Peter MacCallum Cancer Centre, East Melbourne, Australia; Gloucester Pharmaceuticals, Cambridge, MA; Veristat, Inc., Holliston, PA; Royal Free Hospital, London, United Kingdom
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Cabell C, Bates S, Piekarz R, Whittaker S, Kim Y, Godfrey C, Schoonmaker C, McCulloch W, Nichols J, Burris HA. Systematic assessment of potential cardiac effects of the novel histone deacetylase (HDAC) inhibitor romidepsin. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e19533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19533 Background: Romidepsin is a novel pan-HDAC inhibitor with single-agent activity in T-cell lymphoma. HDAC inhibitors reportedly have cardiovascular effects, in particular, QTc prolongation. To systematically and rigorously evaluate the potential cardiac effects of romidepsin, a cardiac safety monitoring plan was developed after discussions with the FDA. Methods: The effect of romidepsin on the change from baseline QTcF (Fridericia's correction) at key pharmacokinetic and pharmacodynamic (PD) time points was investigated. ECGs from 110 pts with advanced malignancies in 3 open-label, clinical studies of romidepsin 14 mg/m2 administered on days 1, 8 and 15 of a 28 day cycle were evaluated by blinded, independent assessors. Results: A mean 2.7 msec increase (90% confidence interval [CI]: 0.2, 5.3) in QTcF interval from a baseline post-antiemetic administration to after infusion of romidepsin was measured. A subanalysis of 74 patients (pts) evaluated QTcF from pre-antiemetic to post-romidepsin showed a mean change in QTcF of 5.0 msec (90% CI: 2.3, 7.7). Thus, antiemetic comedications likely accounts for a portion of the clinically apparent QTc effect. The QTc returned to baseline within 48 hrs. No absolute QTc values >480 msec and no QTc changes >60 msec were observed. No relationship was observed in an analysis of romidepsin plasma concentration versus QT changes. Mean heart rate (HR) increased 10.1±9.0 bpm after romidepsin administration, with a return to baseline by 24 hrs. Several treatment-emergent morphological changes in ECGs (including T wave and ST-segment) were reported. Many of the ECG morphologic abnormalities (determined by automated machine reading) were also observed at baseline. These ECG changes were transient and were not associated with functional cardiovascular changes or with symptoms. Conclusions: Romidepsin has a slight effect on the QT interval but rigorous ECG evaluation found this effect to be mild, below the threshold of regulatory and clinical concern, and not associated with any observed clinical cardiovascular events. Concentration response modeling found no PD relationship between romidepsin concentration and changes in QTcF, but did suggest a relationship between romidepsin concentration and HR. [Table: see text]
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Affiliation(s)
- C. Cabell
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - S. Bates
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - R. Piekarz
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - S. Whittaker
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - Y. Kim
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - C. Godfrey
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - C. Schoonmaker
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - W. McCulloch
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - J. Nichols
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
| | - H. A. Burris
- Quintiles Transnational Corp, Research Triangle Park, NC; National Cancer Institute, Bethesda, MD; Guy's and St. Thomas’ Hospital, London, United Kingdom; Stanford Cancer Center, Stanford, CA; Anoixis Corporation, Natick, MA; Veristat, Inc., Holliston, MA; Gloucester Pharmaceuticals, Cambridge, MA; Sarah Cannon Research Institute, Nashville, TN
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Chaves GM, Bates S, Maccallum DM, Odds FC. Candida albicans GRX2, encoding a putative glutaredoxin, is required for virulence in a murine model. Genet Mol Res 2007; 6:1051-1063. [PMID: 18273798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Resistance of Candida albicans to reactive oxygen species is thought to enhance its virulence in mammalian hosts. Genes such as SOD1, which encodes the anti-oxidant, superoxide dismutase, are known virulence factors. We disrupted the gene GRX2, which encodes a putative glutathione reductase (glutaredoxin) in C. albicans, and we compared the mutant with an sod1Deltamutant. In vitro, the grx2Deltastrain, but not the sod1Delta strain, was defective in hypha formation. The grx2Deltastrain, but not sod1Delta, was significantly more susceptible to killing by neutrophils. When exposed to two compounds that generate reactive oxygen species, both mutants were susceptible to 1 mM menadione, but grx2Deltanull alone was resistant to diamide. Both mutants were attenuated in a murine intravenous challenge model, and a GRX2 reintegrant regained partial virulence. Emphasis on the putative function of products of genes such as SOD1 and GRX2 in resistance to oxidative stress may oversimplify their functions in the virulence process, since the grx2Deltastrain also gave defective hypha formation. Both mutants were sensitive to menadione and were slow to form germ tubes, though growth rates matched controls once the lag phase was passed.
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Affiliation(s)
- G M Chaves
- Aberdeen Fungal Group, School of Medical Sciences, Institute of Medical Sciences, Aberdeen, UK
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Carrier M, Lee A, Bates S, Wells PS. Accuracy and usefulness of a clinical prediction rule and D-dimer testing in excluding deep vein thrombosis (DVT) in cancer patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
19522 Background: Cancer patients frequently present with thrombotic complications and rapid, accurate diagnostic testing would reduce morbidity and mortality. Although the combination of a low clinical probability using clinical prediction rules (e.g. Well’s Score) and a negative D-dimer result have proven to be safe and reliable in ruling out DVT in the general population, the accuracy of such a strategy is less certain in cancer patients. Because cancer patients often have alternative reasons for leg swelling and pain, and because malignancy and chemotherapy can render the D-dimer test positive in the absence of DVT, we hypothesize that the Well’s Score and D-dimer testing are potentially less accurate and less useful in excluding DVT in patients with active cancer. Methods: We performed a retrospective analysis of 2 prospective studies to compare the diagnostic test characteristics of the Well’s Score and D-dimer testing between patients with and without cancer presenting with suspected DVT. Results: A total of 1630 patients were studied; 107 had cancer. DVT was confirmed in 39.3% of patients with and 13.7% of patients without cancer. In both patient groups, the proportions of patients with DVT were significantly different among the high-, moderate- and low-probability groups according to the Well’s score (P<0.001). However, significantly fewer cancer patients (19.6%) had a low-probability score compared to patients without cancer (47.5%) (P<0.001). Similarly, 36.4% of cancer vs. 60.4% of noncancer patients had a negative D-dimer result (P<0.001). In cancer patients, a low probability score alone had a sensitivity of 95.2% (95%CI 82.6%-99.2%) and a specificity of 29.2% (95% CI 18.9%-42.0%). In combination with D-dimer testing, the sensitivity improved to 100% (95%CI 31.0%-100%) but the specificity was reduced to 26.4% (95%CI 13.5%-44.7%). In contrast, the specificity in patients without cancer was preserved at 53.9% (95%CI 50.4%-57.3%). Conclusion: DVT can be ruled out in cancer patients with a low clinical probability of DVT and a negative D-dimer result. However, the low specificity of these tests excludes very few patients and thereby limits their clinical usefulness. No significant financial relationships to disclose.
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Affiliation(s)
- M. Carrier
- University of Ottawa, Ottawa, ON, Canada; MacMaster University, Hamilton, ON, Canada
| | - A. Lee
- University of Ottawa, Ottawa, ON, Canada; MacMaster University, Hamilton, ON, Canada
| | - S. Bates
- University of Ottawa, Ottawa, ON, Canada; MacMaster University, Hamilton, ON, Canada
| | - P. S. Wells
- University of Ottawa, Ottawa, ON, Canada; MacMaster University, Hamilton, ON, Canada
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Jones D, Bates S, Warrillow S, Goldsmith D, Kattula A, Way M, Gutteridge G, Buckmaster J, Bellomo R. Effect of an education programme on the utilization of a medical emergency team in a teaching hospital. Intern Med J 2006; 36:231-6. [PMID: 16640740 DOI: 10.1111/j.1445-5994.2006.01045.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Medical Emergency Teams (MET) have been developed to identify, review and manage acutely unwell ward patients. Previous studies have suggested that there may be obstacles to the utilization and activation of the MET. AIMS To determine the effect of a detailed education programme on the rate of utilization of the MET system 3.5 years after its introduction in a University teaching hospital. METHODS Prospective interventional study involving a detailed programme of education, feedback and decision support for nursing and medical staff given before, during and after implementation of a MET system. We measured the number of MET calls per month for both medical and surgical patients for 109 250 consecutive admissions to the acute care campus of Austin Health from August 2000 to June 2004. RESULTS Overall activation of the MET increased from 25 calls per month to a peak of 79 calls per month over the study period (average increase of one MET call/month). After standardization for monthly admissions, the increase in MET utilization for surgical patients (increase by 1.13 MET/1000 admissions/month) was 4.9-fold greater than for medical patients (increase by 0.23 MET/1000 admissions/month; P < 0.0001). At the peak level of activity (April 2004), the MET was called to review 8.4% of surgical and 2.7% of medical admissions (P < 0.0001). CONCLUSIONS There was a progressive increase in the utilization of the MET service in the 3.5 years after implementation, with the rate of uptake 4.9 times greater for surgical than for medical patients. Sustained uptake of the MET system is possible, but increased utilization may take several years to develop. Short-term studies testing the efficacy of the MET system are likely to significantly underestimate its effect on reducing adverse events. Intensive care unit resource adjustments will become necessary to meet increased demand.
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Affiliation(s)
- D Jones
- Clinical Governance Unit, Melbourne University, Austin Hospital, Victoria, Australia
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Pollock NW, Uguccioni DM, Dear GD, Bates S, Albushies TM, Prosterman SA. Plasma glucose response to recreational diving in novice teenage divers with insulin-requiring diabetes mellitus. Undersea Hyperb Med 2006; 33:125-33. [PMID: 16716063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
A growing number of individuals with insulin-requiring diabetes mellitus (IRDM) dive, but data on plasma glucose (PG) response to diving are limited, particularly for adolescents. We report on seven 16-17 year old novice divers with IRDM participating in a tropical diving camp who had recent at least moderate PG control (HbA1c 7.3 +/- 1.1%) (mean +/- SD). PG was measured at 60, 30 and 10 min pre-dive and immediately following 42 dives. Maximum depth (17 +/- 6 msw) and total underwater times (44 +/- 14 min) were not extreme. Pre-dive PG exceeded 16.7 mmol x L(-1) (300 mg x dL(-1)) in 22% of dives. Males had significantly higher pre-dive levels (15.4 +/- 5.6 mmol x L(-1) [277 +/- 100 mg x dL(-1)] vs. 12.8 +/- 2.9 mmol x L(-1) [230 +/- 52 mg x dL(-1)], respectively) and greater pre-post-dive changes (-4.3 +/- 4.4 mmol x L(-1) [-78 +/- 79 mg x dL(-1)] vs. -0.5 +/- 4.3 mmol x L(-1) [-9 +/- 77 mg x dL(-1)], respectively). Post-dive PG was < 4.4 mmol x L(-1) [< 80 mg x dL(-1)] in two dives by two different males (3.4 and 3.9 mmol x L(-1) [61 and 70 mg x dL(-1)]). No symptoms or complications of hypoglycemia were reported. These data show that in a closely monitored situation, and with benign diving conditions, some diabetic adolescents with good control and no secondary complications may be able to dive safely. The impact of purposeful elevation of PG to protect against hypoglycemia during diving remains to be determined.
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Affiliation(s)
- N W Pollock
- Center for Hyperbaric Medicine and Environmental Physiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
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Menefee ME, Fan C, Edgerly M, Draper D, Chen C, Robey R, Balis F, Figg WD, Bates S, Fojo AT. Tariquidar (XR9576) is a potent and effective P-glycoprotein (Pgp) inhibitor that can be administered safely with chemotherapy. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fojo AT, Menefee ME, Poruchynsky M, Edgerly M, Mickley L, Li Ning Tapia E, Merino M, Balis F, Bates S. A translational study of ixabepilone (BMS-247550) in renal cell cancer (RCC): Assessment of its activity and demonstration of target engagement in tumor cells. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4541] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - F. Balis
- Natl Cancer Inst/NIH, Bethesda, MD
| | - S. Bates
- Natl Cancer Inst/NIH, Bethesda, MD
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Affiliation(s)
- S I Rapaport
- Department of Medicine and Pathology, University of California, San Diego, CA, USA.
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Shepperd S, Perera R, Bates S, Jenkinson C, Hood K, Harnden A, Mant D. A children's acute respiratory illness scale (CARIFS) predicted functional severity and family burden. J Clin Epidemiol 2004; 57:809-14. [PMID: 15485733 DOI: 10.1016/j.jclinepi.2003.12.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2003] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The Canadian Acute Respiratory Illness and Flu Scale (CARIFS) was developed to measure illness severity in children with acute respiratory infection. The objective of this study was to evaluate its performance in a European primary care setting. STUDY DESIGN AND SETTING 178 children (median age 3 years) with cough and fever were recruited in UK general practice. Perceived severity of illness at recruitment was recorded by parents, doctors, and nurses. Parents also completed an illness diary, including the CARIF scale, until their child had recovered. In-depth interviews were conducted with 24 parents. RESULTS Parents found CARIFS relatively easy and quick to complete (78% of parents returned a fully completed diary covering the duration of the illness), internal consistency was high (minimum item correlation with total score 0.22; overall Cronbach's alpha statistic 0.85), and responsiveness to improvement in health was good (observed effect size of 0.45 at 8 h). At presentation, however, neither the overall CARIFS score nor the clinical element of the score correlated with physician assessment of clinical severity. CONCLUSION Of the three recognized domains of illness severity, CARIFS appears to be a good and valid measure of functional severity and burden of illness to the parent but it may not be a good measure of physiological severity.
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Affiliation(s)
- S Shepperd
- Department of Primary Health Care, University of Oxford, IHS Building, Old Road, Oxford OX3 7LF, UK
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Michael M, Mitchell P, Hicks R, Scott A, Ellis A, Thompson M, Hoskins J, Bates S, Tebbutt N, Zalcberg JR. The utility of in-vivo functional and genetic parameters of drug elimination for the estimation of irinotecan (Ir) clearance (CL). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Michael
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - P. Mitchell
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - R. Hicks
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - A. Scott
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - A. Ellis
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - M. Thompson
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - J. Hoskins
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - S. Bates
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - N. Tebbutt
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
| | - J. R. Zalcberg
- Peter MacCallum Cancer Centre, Melbourne, Australia; Austin & Repatriation Medical Centre, Melbourne, Australia; Sydney Cancer Centre, Sydney, Australia
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Piekarz R, Frye R, Turner M, Wright J, Leonard J, Allen S, Bates S. Update on the phase II trial and correlative studies of depsipeptide in patients with cutaneous T-cell lymphoma and relapsed peripheral T-cell lymphoma. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Piekarz
- National Cancer Institute, Bethesda, MD; Cornell University, New York, NY; North Shore University Hospital, Manhasset, NY
| | - R. Frye
- National Cancer Institute, Bethesda, MD; Cornell University, New York, NY; North Shore University Hospital, Manhasset, NY
| | - M. Turner
- National Cancer Institute, Bethesda, MD; Cornell University, New York, NY; North Shore University Hospital, Manhasset, NY
| | - J. Wright
- National Cancer Institute, Bethesda, MD; Cornell University, New York, NY; North Shore University Hospital, Manhasset, NY
| | - J. Leonard
- National Cancer Institute, Bethesda, MD; Cornell University, New York, NY; North Shore University Hospital, Manhasset, NY
| | - S. Allen
- National Cancer Institute, Bethesda, MD; Cornell University, New York, NY; North Shore University Hospital, Manhasset, NY
| | - S. Bates
- National Cancer Institute, Bethesda, MD; Cornell University, New York, NY; North Shore University Hospital, Manhasset, NY
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Fox E, Widemann BC, Chen CC, Van Tellingen O, Riches S, Boniface G, Norris D, Bates S, Fojo T, Balis FM. Pediatric phase I trial and pharmacokinetic study of P-glycoprotein inhibitor, tariquidar, in combination with doxorubicin, vinorelbine or docetaxel. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E. Fox
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - B. C. Widemann
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - C. C. Chen
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - O. Van Tellingen
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - S. Riches
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - G. Boniface
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - D. Norris
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - S. Bates
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - T. Fojo
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
| | - F. M. Balis
- National Cancer Institute, Bethesda, MD; National Institutes of Health, Bethesda, MD; Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Covance, North Yorkshire, United Kingdom; QLT, Inc, Vancouver, BC, Canada; Xenova Group, plc, Berkshire, United Kingdom
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Gila B, Johnson J, Mehandru R, Luo B, Onstine A, Krishnamoorthy V, Bates S, Abernathy C, Ren F, Pearton S. Gadolinium Oxide and Scandium Oxide: Gate Dielectrics for GaN MOSFETs. ACTA ACUST UNITED AC 2001. [DOI: 10.1002/1521-396x(200111)188:1<239::aid-pssa239>3.0.co;2-d] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Talbot M, Bates S. Variability of the symptoms of chronic abacterial prostatitis/chronic pelvic pain syndrome during intermittent therapy with rectal prednisolone foam for ulcerative colitis. Int J STD AIDS 2001; 12:752-3. [PMID: 11589817 DOI: 10.1258/0956462011924137] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe the response of symptoms of chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/PPS) in a man treated with rectal prednisolone for concomitant ulcerative colitis. The temporal relationship of the symptoms of CAP/PPS to starting and stopping the topical corticosteroid over 2 treatment cycles lends further anecdotal support to our hypothesis that treatment of the immune-mediated response in this chronic condition has a beneficial effect upon symptomatic outcome.
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Affiliation(s)
- M Talbot
- Department of Genito-Urinary Medicine, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
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